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Carriage of upper respiratory tract pathogens in rural communities of Sarawak, Malaysian Borneo

Carriage of upper respiratory tract pathogens in rural communities of Sarawak, Malaysian Borneo
Carriage of upper respiratory tract pathogens in rural communities of Sarawak, Malaysian Borneo

Introduction: pneumonia is a leading cause of death in Malaysia. Whilst many studies have reported the aetiology of pneumonia in Western countries, the epidemiology of pneumonia in Malaysia remains poorly understood. As carriage is a prerequisite for disease, we sought to improve our understanding of the carriage and antimicrobial resistance (AMR) of respiratory tract pathogens in Malaysia. The rural communities of Sarawak are an understudied part of the Malaysian population and were the focus of this study, allowing us to gain a better understanding of bacterial epidemiology in this population.

Methods: a population-based survey of bacterial carriage was undertaken in participants of all ages from rural communities in Sarawak, Malaysia. Nasopharyngeal, nasal, mouth and oropharyngeal swabs were taken. Bacteria were isolated from each swab and identified by culture-based methods and antimicrobial susceptibility testing conducted by disk diffusion or E test.

Results: 140 participants were recruited from five rural communities. Klebsiella pneumoniae was most commonly isolated from participants (30.0%), followed by Staphylococcus aureus (20.7%), Streptococcus pneumoniae (10.7%), Haemophilus influenzae (9.3%), Moraxella catarrhalis (6.4%), Pseudomonas aeruginosa (6.4%) and Neisseria meningitidis (5.0%). Of the 21 S. pneumoniae isolated, 33.3 and 14.3% were serotypes included in the 13 valent PCV (PCV13) and 10 valent PCV (PCV10) respectively. 33.8% of all species were resistant to at least one antibiotic, however all bacterial species except S. pneumoniae were susceptible to at least one type of antibiotic.

Conclusion: to our knowledge, this is the first bacterial carriage study undertaken in East Malaysia. We provide valuable and timely data regarding the epidemiology and AMR of respiratory pathogens commonly associated with pneumonia. Further surveillance in Malaysia is necessary to monitor changes in the carriage prevalence of upper respiratory tract pathogens and the emergence of AMR, particularly as PCV is added to the National Immunisation Programme (NIP).

AMR, Carriage, Malaysia, Pathogen, Pneumonia, Respiratory
2200-6133
6
Morris, Denise E
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McNeil, Hannah
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Hocknell, Rebecca E
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Anderson, Rebecca
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Tuck, Andrew C
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Tricarico, Serena
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Norazmi, Mohd Nor
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Lim, Victor
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Siang, Tan Cheng
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Lim, Patricia Kim Chooi
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Wie, Chong Chun
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Cleary, David W
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Yap, Ivan Kok Seng
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Clarke, Stuart C
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Mcgrath, Nuala
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Faust, Saul
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Roderick, Paul
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MYCarriage group
Morris, Denise E
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McNeil, Hannah
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Hocknell, Rebecca E
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Anderson, Rebecca
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Tuck, Andrew C
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Tricarico, Serena
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Norazmi, Mohd Nor
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Lim, Victor
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Siang, Tan Cheng
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Lim, Patricia Kim Chooi
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Wie, Chong Chun
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Cleary, David W
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Yap, Ivan Kok Seng
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Clarke, Stuart C
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Mcgrath, Nuala
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Faust, Saul
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Roderick, Paul
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Morris, Denise E, McNeil, Hannah, Hocknell, Rebecca E, Anderson, Rebecca, Tuck, Andrew C, Tricarico, Serena, Norazmi, Mohd Nor, Lim, Victor, Siang, Tan Cheng, Lim, Patricia Kim Chooi, Wie, Chong Chun, Cleary, David W, Yap, Ivan Kok Seng and Clarke, Stuart C , MYCarriage group (2021) Carriage of upper respiratory tract pathogens in rural communities of Sarawak, Malaysian Borneo. Pneumonia, 13 (1), 6. (doi:10.1186/s41479-021-00084-9).

Record type: Article

Abstract

Introduction: pneumonia is a leading cause of death in Malaysia. Whilst many studies have reported the aetiology of pneumonia in Western countries, the epidemiology of pneumonia in Malaysia remains poorly understood. As carriage is a prerequisite for disease, we sought to improve our understanding of the carriage and antimicrobial resistance (AMR) of respiratory tract pathogens in Malaysia. The rural communities of Sarawak are an understudied part of the Malaysian population and were the focus of this study, allowing us to gain a better understanding of bacterial epidemiology in this population.

Methods: a population-based survey of bacterial carriage was undertaken in participants of all ages from rural communities in Sarawak, Malaysia. Nasopharyngeal, nasal, mouth and oropharyngeal swabs were taken. Bacteria were isolated from each swab and identified by culture-based methods and antimicrobial susceptibility testing conducted by disk diffusion or E test.

Results: 140 participants were recruited from five rural communities. Klebsiella pneumoniae was most commonly isolated from participants (30.0%), followed by Staphylococcus aureus (20.7%), Streptococcus pneumoniae (10.7%), Haemophilus influenzae (9.3%), Moraxella catarrhalis (6.4%), Pseudomonas aeruginosa (6.4%) and Neisseria meningitidis (5.0%). Of the 21 S. pneumoniae isolated, 33.3 and 14.3% were serotypes included in the 13 valent PCV (PCV13) and 10 valent PCV (PCV10) respectively. 33.8% of all species were resistant to at least one antibiotic, however all bacterial species except S. pneumoniae were susceptible to at least one type of antibiotic.

Conclusion: to our knowledge, this is the first bacterial carriage study undertaken in East Malaysia. We provide valuable and timely data regarding the epidemiology and AMR of respiratory pathogens commonly associated with pneumonia. Further surveillance in Malaysia is necessary to monitor changes in the carriage prevalence of upper respiratory tract pathogens and the emergence of AMR, particularly as PCV is added to the National Immunisation Programme (NIP).

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s41479-021-00084-9 - Version of Record
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More information

Accepted/In Press date: 22 March 2021
e-pub ahead of print date: 25 April 2021
Published date: 25 April 2021
Keywords: AMR, Carriage, Malaysia, Pathogen, Pneumonia, Respiratory

Identifiers

Local EPrints ID: 450134
URI: http://eprints.soton.ac.uk/id/eprint/450134
ISSN: 2200-6133
PURE UUID: f1f7ee6e-7f8c-44e3-9581-67a33614bbc5
ORCID for Serena Tricarico: ORCID iD orcid.org/0000-0002-1737-8697
ORCID for David W Cleary: ORCID iD orcid.org/0000-0003-4533-0700
ORCID for Stuart C Clarke: ORCID iD orcid.org/0000-0002-7009-1548
ORCID for Nuala Mcgrath: ORCID iD orcid.org/0000-0002-1039-0159
ORCID for Saul Faust: ORCID iD orcid.org/0000-0003-3410-7642
ORCID for Paul Roderick: ORCID iD orcid.org/0000-0001-9475-6850

Catalogue record

Date deposited: 13 Jul 2021 16:30
Last modified: 17 Mar 2024 03:35

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Contributors

Author: Denise E Morris
Author: Hannah McNeil
Author: Rebecca E Hocknell
Author: Rebecca Anderson
Author: Andrew C Tuck
Author: Serena Tricarico ORCID iD
Author: Mohd Nor Norazmi
Author: Victor Lim
Author: Tan Cheng Siang
Author: Patricia Kim Chooi Lim
Author: Chong Chun Wie
Author: David W Cleary ORCID iD
Author: Ivan Kok Seng Yap
Author: Stuart C Clarke ORCID iD
Author: Nuala Mcgrath ORCID iD
Author: Saul Faust ORCID iD
Author: Paul Roderick ORCID iD
Corporate Author: MYCarriage group

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